Quality

The Institute of Medicine (IOM) defined quality as "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." [Internet]. Institute of Medicine, Committee on Quality of Health Care in America. Washington, DC: National Academy Press; 2001 [cited 7 October 2010].

Related to Quality is the topic of patient safety/medical errors. For additional information, please visit the NLM MedlinePlus page on patient safety and the AHRQ page on patient safety and medical errors.

Information on this page is not an index of all quality health services research resources on the Web. Rather, this page contains selective links representing a sample of available information. Items are selected for their quality, authority of authorship, uniqueness, and appropriateness.

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AHRQ Quality Indicators
- (Agency for Healthcare Research and Quality (AHRQ))
- Set of quality indicators organized into four "modules," each of which measures quality associated with processes of care that occurred in an outpatient or an inpatient setting to highlight potential quality concerns, identify areas that need further study and investigation, and track changes over time.

AHRQ Quality Indicators™ Toolkit for Hospitals
- (Agency for Healthcare Research and Quality (AHRQ))
- This toolkit is designed to help hospitals understand the AHRQ Quality Indicators (QIs) and support the use of them to successfully improve quality and patient safety in hospitals. The toolkit is a general guide to using improvement methods, with a particular focus on the QIs. It focuses on the 17 Patient Safety Indicators (PSIs) and the 28 Inpatient Quality Indicators (IQIs).

AHRQ's State Snapshots
- (Agency for Healthcare Research and Quality (AHRQ))
- Provides state-specific health care quality information, including strengths, weaknesses, and opportunities for improvement. The goal is to help state officials and their public- and private-sector partners better understand health care quality and disparities in their state.

Community Tool to Align Measurement
- (National Quality Forum (NQF) USA)
- NQF's Community Tool to Align Measurement (Alignment Tool), developed in collaboration with the 16 Robert Wood Johnson Foundation - Aligning Forces for Quality (AF4Q) community alliances, supports decisions to align measurement and public reporting. The Alignment Tool is a snapshot in time (as of February 2012) of the measures in use by the 16 AF4Q Alliances.

e-Source: Behavioral and Social Science Research
- (Office of Behavioral and Social Sciences Research, NIH (OBSSR))
- This website provides access to 20 interactive chapters with authoritative answers to methodological questions on behavioral and social science research. With contributions from a team of international experts, this anthology provides the latest information on addressing emerging challenges in public health.

Health System Measurement Project
- (Department of Health and Human Services (HHS) U.S.)
- This web tool enables the viewing of data on a given topical area from multiple sources, comparing trends across measures and national trends with those at the state and regional level. For example, an individual could use the Measurement Project to monitor the percentage of people who have a specific source of ongoing medical care or track avoidable hospitalizations for adults and children by region or ethnic group.

Healthcare Communities
- (Health Resources and Services Administration (HRSA))
- HealthcareCommunities.org (HC) is a web-based knowledge management system that provides multiple means for the healthcare quality improvement community to share knowledge and contribute to each others' QI work.

Hospital Compare
- (Centers for Medicare & Medicaid Services (CMS))
- Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. On this site, the consumer can see the recommended care that an adult should get if being treated for a heart attack, heart failure, or pneumonia or having surgery

HSRR (Health Services and Sciences Research Resources)
- (National Library of Medicine, National Information Center on Health Services Research and Health Care Technology)
- HSRR is a searchable database of information about research datasets, instruments/indices and software employed in Health Services Research, the Behavioral and Social Sciences and Public Health. The database includes brief descriptions of research resources and links to PubMed.

Improving Your Office Testing Process
- (Agency for Healthcare Research and Quality (AHRQ))
- This toolkit is designed to assist physicians' offices, clinics, and other ambulatory care facilities assess and improve the testing process in their offices.

Institute for Healthcare Improvement (IHI) Map
- (Institute for Healthcare Improvement (IHI))
- This map is a free, open resource for those interested in sharing IHI's mission of improving health care. This includes access to various "How To Guides," for example, prevent ventilator-associated pneumonia; prevent surgical site infection; prevent adverse drug events, etc.

Kaiser Family Foundation's State Health Facts Online
- (Kaiser Family Foundation (KFF) US)
- Provides free, up-to-date, and easy-to-use health data on all 50 states with data on health status, health coverage and uninsured, and more than other 700 health topics.

Leading Health Indicators
- (Department of Health and Human Services (HHS) U.S.)
- Healthy People 2020 provides a comprehensive set of 10-year, national goals and objectives for improving the health of all Americans.

National Database of Nursing Quality Indicators
- (American Nurses Association (ANA) USA)
- Proprietary database of the American Nurses Association. The database collects and evaluates unit-specific nurse-sensitive data from hospitals in the United States.

National Practitioner Data Banks
- (Health Resources and Services Administration (HRSA))
- The Division of Practitioner Data Banks (DPDB) is responsible for the implementation of the National Practitioner Data Bank (NPDB) and Healthcare Integrity and Protection Data Bank (HIPDB). The NPDB and HIPDB are alert or flagging systems intended to facilitate a comprehensive review of the professional credentials of health care practitioners, providers, and suppliers

NHQRDRNet Online Query System
- (Agency for Healthcare Research and Quality (AHRQ))
- Online query system that allows you to access national and state data on the quality of, and access to, health care from scientifically credible measures and data sources. This is an interactive tool to explore data from the National Healthcare Quality & Disparities Reports.

Patient Safety Network
- (Agency for Healthcare Research and Quality (AHRQ))
- A web-based resource featuring the latest news and essential resources on patient safety. The site offers weekly updates of patient safety literature, news, tools, and meetings ("What's New"), and a vast set of carefully annotated links to important research and other information on patient safety ("The Collection").

PROSPERO
- (University of York UK)
- PROSPERO consists of over 800 records, giving details of systematic reviews being undertaken in 33 different countries.

The Quality Data Set (QDS) Framework
- (National Quality Forum (NQF) USA)
- Provides a common technological framework for defining clinical data necessary to measure performance and accelerate improvement in patients' quality of care. By providing a common language to describe the information within quality measures, the QDS enables quality measurement from a variety of electronic sources, including electronic health records (EHRs), personal health records (PHRs), registries, and health information exchanges (HIEs). The QDS framework is applicable to all care settings a patient is likely to use in his or her lifetime. This QDS framework creates a dynamic product that will enable versioning, growth, and expansion to meet future needs for measurement and guideline implementation.

QualityNet
- (Centers for Medicare & Medicaid Services (CMS))
- Tool for use by hospitals to electronically submit their notice of participation for the Hospital Inpatient Quality Reporting Program- formerly known as Reporting Hospital

Re-Engineered Discharge (RED) Toolkit
- (Agency for Healthcare Research and Quality (AHRQ))
- This toolkit was designed to assist hospitals in reducing readmissions and posthospital emergency department visits. It is specifically designed for those institutions serving diverse populations. It introduces a new component of overcoming language barriers and literacy issues.

Resources for State and Local Leaders
- (National Quality Forum (NQF) USA)
- Here is a handy list to help those who use NQF-endorsed measures easily access some of the key NQF tools and resources. As the number of State and community leaders involved in measurement and public reporting grows, NQF is committed to helping streamline and support those important efforts.

Tools: Interactive Tables and Data
- (National Center for Health Statistics, CDC (NCHS))
- The Community Health Data Initiative is a collaborative effort among government and non-government partners to establish a network of suppliers and demanders of community health data, indicators, and interventions. Its purpose is to help Americans understand health and health care system performance in their communities, thereby sparking and facilitating action to improve performance and value.

VA Hospital Compare and ASPIRE
- (Health Services Research and Development Service, Veterans Administration (HSR&D))
- Key elements of the VA's transparency initiative involve public presentation of health system and facility data about quality of care and safety. Examples include VA's Hospital Compare website, which provides outcomes and process data for selected diagnoses, and the ASPIRE dashboard, which reports quality and safety goals for all VA hospitals.

Why Not the Best? Comparative Health Care Performance Data
- (Commonwealth Fund)
- Free resource for health care professionals interested in tracking performance on various measures of health care quality. It enables organizations to compare their performance against that of peer organizations, against a range of benchmarks, and over time. Case studies and improvement tools spotlight successful improvement strategies of the nation's top performers.

2012 Annual Progress Report to Congress on the National Strategy for Quality Improvement in Health Care (National Quality Strategy)
- (Department of Health and Human Services (HHS) U.S.)
- Since the release of the National Quality Strategy, HHS has launched nationwide initiatives to improve health care quality in each of the six priorities set by the National Quality Strategy. This report describes many of these current efforts, including Partnership for Patients and Million Hearts. As its implementation proceeds, the National Quality Strategy will be periodically refined, based on lessons learned in the public and private sectors, emerging best practices, new research findings, and the changing needs of the Nation.

Equity of Care Blog
- (Equity of Care US)
- Updated biweekly, this blog provides commentary by leaders in the field who are taking up the challenge of improving the quality of care for all patient populations and eliminating health care disparities.

Health Indicators: a 4-Part Webinar Series
- (National Library of Medicine, National Information Center on Health Services Research and Health Care Technology)
- Recorded webinar series that provides an overview of health indicators, an in-depth review of a county-level indicator project, practical approaches in using health indicator data to engage with communities, and an exploration of several important new indicator efforts.

Key Indicator Systems: Experiences of Other National and Subnational Systems Offer Insights for the United States
- (Government Accountability Office (GAO) US)
- This March 2011 report report concludes that key indicator systems are used for multiple purposes and cites "increasing transparency and public awareness; fostering civic engagement and collaboration; and monitoring progress, aiding decision making, and promoting accountability" among the uses of the systems studied. For example, the study found that many systems, particularly ones that have a local focus, incorporate public input in identifying goals and priorities, which in turn influence indicator selection. Systems may facilitate conversations among diverse members of a community about ways to address problems, and may identify problems that were previously unrecognized.

Patient Identification and Matching: Final Report
- (Office of the National Coordinator for Health Information Technology, HHS (ONC))
- The issue of correctly matching the patient to their EHR is the subject of this report, which includes best practices for patient safety and information security.

Patient-Centered Care Improvement Guide
- (Picker Institute US, Planetree US)
- Founded 30 years ago, Planetree is a not-for-profit organization that partners with healthcare organizations to transform organizational cultures and improve the patient experience; the Picker Institute is an international non-profit organization that supports research in the field of patient-centered care. The Patient-Centered Care Improvement Guide represents the culmination of this year-long collaboration. It reflects the collective wisdom of organizations implementing patient-centered care at an advanced level, as well as the experiences of those whose efforts have been hindered by any number of barriers.

Priority Areas for National Action: Transforming Health Care Quality
- (Institute of Medicine (IOM))
- This January 2003 report recommends a set of 20 priority areas that the U.S. Department of Health and Human Services (DHHS) and other groups in the public and private sectors should focus on to improve the quality of health care delivered to all Americans.

Public Health Foundation
- (Public Health Foundation (PHF))
- With a contribution from the National Library of Medicine, the Public Health Foundation (PHF) developed a Quality Improvement (QI) Quick Guide for public health practitioners, which was launched online in August 2010. The QI Quick Guide addresses a need identified by public health practitioners for assistance in determining which resources to use as they pursue QI initiatives.

Quality Improvement & Risk Management Training
- (Health Services Research and Development Service, Veterans Administration (HSR&D))
- Learn about how to design and implement a successful Quality Improvement program that meets core program and FTCA requirements and drives quality-related activities from this website.

Report to Congress: National Strategy for Quality Improvement in Health Care
- (Department of Health and Human Services (HHS) U.S.)
- This March 2011 report outlines a national strategy for quality improvement in health care. The strategy was called for under the Affordable Care Act and is the first effort to create national aims and priorities to guide local, state, and national efforts to improve the quality of health care in the United States.

Risk Adjustment for Sociodemographic Factors
- (National Quality Forum (NQF) USA)
- This project seeks to develop a set of recommendations on the inclusion of socioeconomic status and other factors such as race and ethnicity in risk adjustment for outcome and resource use performance measures.

TalkingQuality.Gov
- (Agency for Healthcare Research and Quality (AHRQ))
- TalkingQuality is a comprehensive resource and guide for organizations that produce and disseminate reports to consumers on the quality of care provided by health care organizations (e.g., hospitals, health plans, medical groups, nursing homes) and individual physicians.

Academy for Healthcare Improvement
- (Academy for Healthcare Improvement US)
- The aim of this organization is to foster an interprofessional community that advances quality improvement in health care through scholarly and educational activities.

AHRQ Health Care Innovations Exchange
- (Agency for Healthcare Research and Quality (AHRQ))
- Comprehensive program designed to accelerate the development and adoption of innovations in health care delivery.

The American Health Quality Association (AHQA)
- Represents Quality Improvement Organizations (QIOs) and professionals working to improve the quality of health care in communities across America. QIOs share information about best practices with physicians, hospitals, nursing homes, home health agencies, and others.

American Medical Association - Physician Consortium for Performance Improvement (PCPI)
- (American Medical Association (AMA))
- Comprised of more than 170 national medical specialty societies, state medical societies, the American Board of Medical Specialties and member boards, Council of Medical Specialty Societies, health care professional organizations, federal agencies, individual members and others interested in improving the quality and efficiency of patient care, PCPI is committed to enhancing quality of care and patient safety by taking the lead in the development, testing, and maintenance of evidence-based clinical performance measures and measurement resources for physicians.

Assistant Secretary for Planning and Evaluation (ASPE)
- (Department of Health and Human Services (HHS) U.S.)
- Principal advisor to the Secretary of the U.S. Department of Health and Human Services on policy development, and is responsible for major activities in policy coordination, legislation development, strategic planning, policy research, evaluation, and economic analysis.

Center for Medicare & Medicaid Innovation
- (Centers for Medicare & Medicaid Services (CMS))
- Established by the Affordable Care Act, the Center for Innovation is a new engine for revitalizing and sustaining Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) as well as for improving the health care system for all Americans. The Innovation Center tests innovative care and payment models and encourages widespread adoption of practices that deliver better health care at lower costs.

Division of Healthcare Quality Promotion (DHQP)
- (Centers for Disease Control and Prevention (CDC))
- Mission is to protect patients and healthcare personnel and promote safety, quality, and value in the healthcare delivery system by providing national leadership.

FDA's Sentinel Initiative
- (Food and Drug Administration (FDA))
- Launched in May 2008 by FDA, the Sentinel Initiative aims to develop and implement a proactive system that will complement existing systems that the Agency has in place to track reports of adverse events linked to the use of its regulated products.

HealthIT.gov
- (Office of the National Coordinator for Health Information Technology, HHS (ONC))
- Resource to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care.

Hospital Quality Alliance
- National public-private collaboration that is committed to making meaningful, relevant, and easily understood information about hospital performance accessible to the public and to informing and encouraging efforts to improve quality.

HRSA Quality Improvement and Safety Net Providers
- (Health Resources and Services Administration (HRSA))
- The HRSA-supported health care safety net cares for millions of people in the U.S. each year. The services and patients are diverse, but the providers are united in their commitment to quality health care. Quality health care is the provision of appropriate services to individuals and populations that are consistent with current professional knowledge, in a technically competent manner, with good communication, shared decision-making, and cultural sensitivity.

Improvement Science Research Network
- A NIH-supported improvement research network. The ISRN's primary mission is to accelerate interprofessional improvement science in a systems context across multiple hospital sites.

Innovation in Medical Evidence Development and Surveillance (IMEDS)
- IMEDS serves to advance the science and tools necessary to support post-market evidence generation on regulated products and to facilitate utilization of a robust secondary electronic healthcare data platform for generating better evidence on regulated products in the post-market settings.

Innovations
- (California HealthCare Foundation (CHCF))
- A variety of reports, webcasts, websites and other information that promote models of care aimed at producing a higher-quality, and lower-cost health care system in California.

Institute for Healthcare Improvement (IHI)
- IHI focuses on motivating and building the will for change; identifying and testing new models of care in partnership with both patients and health care professionals; and ensuring the broadest possible adoption of best practices and effective innovations.

Integrating Quality Initiative
- (Association of American Medical Colleges (AAMC))
- Information on the program, and on their regular meetings and events are included.

Laboratory Quality Assurance and Standardization Programs
- (Centers for Disease Control and Prevention (CDC))
- Given the importance of laboratory test results, the CDC has programs to help assure the quality of these data so patients and healthcare providers (as well as researchers and public health officials) can be confident that laboratory test results they receive are accurate.

The LeapFrog Group
- Voluntary program aimed at mobilizing employer purchasing power to alert America's health industry that big leaps in health care safety, quality and customer value will be recognized and rewarded.

Medical Outcomes Trust
- (Medical Outcomes Trust)
- Not for profit organization dedicated to improving health and health care by promoting the science of outcomes measurement, and the development, evaluation, and distribution of standardized, high quality instruments that measure health and the outcomes of medical care.

Medicare Payment Advisory Commission (MedPAC)
- Established in 1997 by the merger of the Physician Payment Review Commission (PPRC) and the Prospective Payment Assessment Commission (ProPAC). Created by congressional mandate (Public Law 105-33), the 15-member nonpartisan Commission advises the Congress on Medicare Payment policies. MedPAC is also tasked with analyzing access to care, quality of care, and other issues affecting Medicare.

National Practitioner Data Banks
- (Health Resources and Services Administration (HRSA))
- The Division of Practitioner Data Banks (DPDB) is responsible for the implementation of the National Practitioner Data Bank (NPDB) and Healthcare Integrity and Protection Data Bank (HIPDB). The NPDB and HIPDB are alert or flagging systems intended to facilitate a comprehensive review of the professional credentials of health care practitioners, providers, and suppliers

National Quality Forum (NQF)
- Not-for-profit membership organization created to develop and implement a national strategy for health care quality measurement and reporting.

Network for Regional Healthcare Improvement (NRHI)
- NHRI is a National Coalition of Regional Health Improvement Collaboratives -- regionally-based, multi-stakeholder organizations that are working to improve the quality and value of health care delivery.

PROMIS - Patient-Reported Outcomes Measurement System ®
- (National Institutes of Health (NIH))
- Network of NIH-funded primary research sites and coordinating centers working collaboratively to develop a series of dynamic tools to reliably and validly measure patient-reported outcomes (PROs).

Quality Alliance Steering Committee
- A collaborative effort among a variety of key stakeholders, the Committee is working to make consistent and useful information about the quality and cost of health care widely available.

Quality and Patient Safety
- (Institute of Medicine (IOM))
- The IOM focuses on patient safety in order to promote policies and best practices that create safe and high-quality health care environments. Access related activities, Boards, and reports.

Robert Wood Johnson Foundation, Health Care Quality
- (Robert Wood Johnson Foundation (RWJF))
- The Health Care Quality Portfolio of the Robert Wood Johnson Foundation remains active in the public reporting of quality and price information, which include our support of The Dartmouth Atlas, The Prometheus Payment Project, the Consumer-Purchaser Disclosure Project, National Quality Forum and others.

Assistant Secretary for Planning and Evaluation Quality Guidelines
- (Department of Health and Human Services (HHS) U.S.)
- This site presents the HHS Information Quality Guidelines, the supporting administrative mechanisms to request correction of information covered under the guidelines, the Annual Information Quality Reports, and the HHS Peer Review Agenda. The HHS Guidelines were developed in accordance with the provisions of P.L. 106-554 and OMB government-wide requirements directing all federal agencies to issue guidelines for ensuring the quality of the information that they disseminate to the public.

Mammography Quality Standards Act and Program
- (Food and Drug Administration (FDA))
- Information for mammography facility personnel, inspectors, and consumers about the implementation of the Mammography Quality Standards Act of 1992 (MQSA). The FDA adminsters several quality and standards activities. This is one example.

AHRQ 2010 Annual Conference
- (Agency for Healthcare Research and Quality (AHRQ))
- AHRQ held its fourth annual conference on September 26-29, 2010, in Bethesda, MD. This conference, entitled "Better Care, Better Health: Delivering on Quality for All Americans," showcased leading authorities in health care research and policy in sessions on transforming health care delivery; developing new patient care models; strengthening preventive care and reducing health disparities; improving quality and patient safety; and measuring and reporting on provider and system performance.

The Innovation Center: How Much Can It Improve Quality and Reduce Costs - and How Quickly?
- (Alliance for Health Reform US, Commonwealth Fund)
- The new Center for Medicare and Medicaid Innovation (CMMI) seeks to test new health care payment and service delivery models that can potentially enhance quality of care for beneficiaries while reducing costs. How is the agency planning to administer its $10 billion in funding? What early projects is the center undertaking? Is there private sector evidence that its goals can be achieved? What will happen to existing innovations now being rolled out by providers and hospitals? This July 2011 briefing addressed these and related questions.

National Quality Forum's Annual Conference
- (National Quality Forum (NQF) USA)
- Each year the National Quality Forum hosts a conference in Washington, DC. The two-day event includes a membership meeting and public sessions addressing key policy and implementation issues. This site links to wrap-up documents for prior meetings.

National Quality Forum's Annual Conference
- (National Quality Forum (NQF) USA)
- Each year the National Quality Forum hosts a conference in Washington, DC. The two-day event includes a membership meeting and public sessions addressing key policy and implementation issues. This site links to wrap-up documents for prior meetings.